Relação entre indicadores de risco à saúde e componentes do somatótipo consoante atividade física em crianças / Relación entre indicadores de riesgo para la salud y componentes del somatótipo según la actividad física en niños / Relationship between health risk indicators and somatotype components according to physical activity in children

Este estudo analisou a relação entre indicadores de risco à saúde e as componentes do somatótipo consoante os níveis de atividade física em crianças. Trata-se de uma pesquisa epidemiológica de base escolar, composta por 168 crianças (6 a 11 anos) de ambos os sexos. Informações demográficas foram obtidas. Avaliações antropométricas (estatura; massa corporal; pregas de adiposidade subcutânea; perímetros do braço contraído, cintura, quadril e panturrilha), pressão arterial sistólica e diastólica, e atividade física (ativo; inativo) foram mensuradas. O somatótipo, razão cintura-quadril e razão cintura-estatura foram calculados. Análise de comparação, correlação e regressão linear múltipla foram realizadas, considerando intervalo de confiança de 95%. Meninos apresentaram maior número de passos, razão cintura-quadril e cintura-estatura. Crianças ativas eram mais velhas, possuíam maior perímetro de cintura, quadril e pressão arterial sistólica. No grupo fisicamente ativo, o sexo esteve associado diretamente ao perímetro de cintura e razão cintura-estatura, enquanto a idade associou-se com a perímetro de quadril e pressão arterial diastólica. Nas crianças inativas, todas as variáveis preditoras (exceto para a variável sexo em relação ao perímetro de quadril) mostraram-se significativas para o perímetro da cintura e quadril, explicando, conjuntamente, ~83% e 85% da expressão destas variáveis, respectivamente. A relação entre indicadores de risco à saúde e as componentes do somatótipo foi maior em crianças inativas. Independentemente do nível de atividade física, a endomorfia mostrou relação significativa com os componentes de saúde, com maior efeito no grupo inativo, tendo em vista a associação com a composição corporal dos sujeitos.

Este estudio analizó la relación entre indicadores de riesgo para la salud y los componentes del somatótipo según los niveles de actividad física en niños. Se trata de una investigación epidemiológica, compuesta por 168 niños (6 a 11 años) de ambos sexos. Fueron mensuradas: evaluaciones antropométricas (estatura; masa corporal; pliegues de adiposidad subcutánea; perímetros del brazo contraído, cintura, cuadril y pantorrilla), presión arterial sistólica y diastólica, y actividad física (activo/inactivo); el somatótipo, a través del cálculo de: razón cintura-cuadril y razón cintura-estatura. Se realizó el análisis de comparación, correlación y regresión lineal múltiple, considerando intervalo de confianza del 95%. Los niños presentaron mayor número de pasos, razón cintura-cuadril y cintura-estatura. Los niños activos eran mayores, tenían mayor perímetro de cintura, cuadril y presión arterial sistólica. En el grupo físicamente activo, el sexo estuvo asociado directamente al perímetro de cintura y razón cintura-estatura, mientras que la edad se asoció con el perímetro de cuadril y presión arterial diastólica. En los niños inactivos, todas las variables predictoras (excepto para la variable sexo con relación al perímetro de cuadril) se mostraron significativas para el perímetro de la cintura y cuadril, explicando, conjuntamente, ~83% y 85% de la expresión de estas variables, respectivamente. La relación entre indicadores de riesgo para la salud y los componentes del somatotipo fue mayor en niños inactivos. Independientemente del nivel de actividad física, la endomorfia mostró una relación significativa con los componentes de salud, con mayor efecto en el grupo inactivo, con vistas a la asociación con la composición corporal de los sujetos.

This study analysed the relationship between health risk indicators and somatotype components according to physical activity levels in children. This epidemiological and school-based research comprised 168 children of both sexes (56% boys), aged between 6 to 11 years. Demographic information (sex, age) was obtained. Anthropometric information (body height; body mass; contracted arm, waist, hip, and calf circumferences), body composition (subcutaneous adiposity and somatotype), systolic and diastolic blood pressure, and physical activity level (active; inactive) were measured. The waist-hip ratio and waist-to-height ratio were computed. Comparison, correlation, and multiple linear regression analysis were performed, considering 95% of the confidence interval. Boys presented higher values for physical activity, waist-hip, and waist-to-height ratio. Active children were older, had a larger waist and hip circumference, and higher systolic blood pressure. Among the active group, sex was associated with waist circumference and waist-to-height ratio, while age was associated with hip circumference and diastolic blood pressure. Among inactive children, all predictors (except for sex for hip circumference) were significantly associated with waist and hip circumferences, explaining ≅83% and 85% of the expression of these variables, respectively. The relationship between health risk indicators and somatotype components was higher among inactive children. Regardless of the physical activity level, the endomorphic component shows a significant relationship with health components, with a higher effect among the inactive group, considering the body composition association.

Vacunación de BCG en el medio rural y la importancia del conocimiento de sus beneficios / BCG vaccination in rural areas and the importance of knowledge of its benefits

Objetivo General: Establecer nivel de conocimiento sobre tuberculosis y vacuna, BCG., de padres y representantes, en Ambulatorio Gabriel Trompiz, Tucacas, Estado Falcón. Metodología: Es un estudio descriptivo de tipo transversal, con una muestra poblacional de 180 madres, padres y representantes entre octubre y diciembre de 2022. Se utilizaron encuestas, formularios elaborados y validados en estudios anteriores; la información fue procesada con el programa estadístico Microsoft Excel. Resultados: la mayor parte de la población respondió que la tuberculosis es una enfermedad producida por un virus, con respecto a la importancia de las inmunizaciones, un 20% desconocía la importancia de la vacunación. El 77% conocían información básica acerca de la vacuna BCG. En cuanto a las enfermedades prevenibles por esta vacuna, un 54% respondió que se trataba sobre la tuberculosis, mientras que casi la mitad de la población estudiada tenía la creencia que tenía que ver con el resfriado común. El 72% de la población considera que la fiebre es una contraindicación para la aplicación de la vacuna BCG. Se demostró que existía una gran desinformación con respecto a la vacunación en la población infantil en el medio rural venezolano(AU)

To establish the level of knowledge about tuberculosis and BCG vaccine., of parents and representatives in the Gabriel Trompiz outpatient clinic, Tucacas, Falcon State. Methodology: it is a descriptive cross-sectional study, with a population sample of 180 mothers, fathers and representatives between October and December 2022. Surveys, forms prepared and validated in previous studies were used, the information was processedwith the Microsoft Excel statistical program. Results: most of the population answered that tuberculosis was a disease caused by a virus, regarding the importance of immunizations, 20% were unaware of the importance of vaccination. 77% knew basic information about the BCG vaccine. Regarding the diseases preventable by this vaccine, 54% answered that it was about tuberculosis, while almost half of the population studied believed that it had to do with the common cold. 72% of the population considers that fever is a contraindication for the application of the BCG vaccine. It was demonstrated that there was a great amount of misinformation regarding vaccination in the child population in rural Venezuela(AU)

La pediatría social. Herramienta necesaria para combatir la pandemia de COVID-19 en Cuba

Introducción: La pediatría social se orienta hacia la atención integral del niño. Estudia las causas sociales que alteran su salud y también los problemas de esta índole que repercuten en su entorno social. En el contexto de la actual pandemia, caracterizada por alta morbilidad y mortalidad, se produjeron significativas consecuencias psicosociales. Objetivo: Describir el impacto de la pediatría social sobre la salud infanto-juvenil durante la pandemia de COVID-19. Métodos: Se realizó una revisión en las bases de datos bibliográficas PubMed y BVS. Se empleó el Google Académico como motor de búsqueda. Se utilizaron, en español y en inglés, los siguientes descriptores: pediatría social, pandemia COVID-19, aislamiento social, bienestar psicológico, salud mental y población pediátrica. Análisis y síntesis de la información: Se expusieron argumentos desde la mirada psicosocial del pediatra, relacionados con el desarrollo y el bienestar socioemocional de los niños, y la repercusión sobre ellos del aislamiento social; además, se describió el impacto de la pandemia en la infancia, y el papel desempeñado por el especialista y otros profesionales vinculados con la atención pediátrica. Conclusiones: La pandemia se caracterizó por afectar todas las esferas de la vida del niño. La pediatría social resultó indispensable en el enfrentamiento de las consecuencias médico-biológicas, psicológicasy sociales que ocasionó el azote de la COVID-19, por lo que su rol influyó en el restablecimiento del equilibrio biopsicosocial de la población infantil.

Introduction: Social pediatrics is oriented towards the comprehensive care of children. It studies the social causes that alter their health, and also the problems of this nature that affect their social environment. In the context of the current pandemic, characterized by high morbidity and mortality, there were significant psychosocial consequences. Objective: To describe the impact of social pediatrics on children and adolescents health during the COVID-19 pandemic. Methods: A review was conducted in the bibliographic databases PubMed and VHL. Google Scholar was used as a search engine. The following descriptors were used in Spanish and English: social pediatrics, COVID-19 pandemic, social isolation, psychological well-being, mental health and pediatric population. Analysis and synthesis of information: Arguments were presented from the psychosocial perspective of the pediatrician, related to the development and socio-emotional well-being of children, and the impact on them of social isolation. In addition, the impact of the pandemic on children was described, and the role played by the specialists and other professionals linked to pediatric care. Conclusions: The pandemic was characterized by affecting all spheres of the child's life. Social pediatrics was indispensable in confronting the medical-biological, psychological and social consequences caused by the scourge of COVID-19, so its role influenced the restoration of the biopsychosocial balance of the children population.

Características epidemiológicas en pacientes pediátricos con COVID-19 durante la primera ola pandémica / Experience in pediatric patients with COVID-19 during the first pandemic wave

Resumen La infección por SARS-CoV-2 se ha extendido en todo el mundo. La mayoría de las publicaciones describen un comportamiento diferente entre población adulta y pediátrica, esta última asociada a menor gravedad y morbimortalidad. El objetivo del trabajo fue analizar el proceso de atención, las característi cas clínicas epidemiológicas, la evolución y la utilización de recursos en pacientes pediátricos asistidos durante la primera ola pandémica a principio del 2020. Se realizó un estudio observacional, retrospectivo, descriptivo y analítico de pacientes pediátricos con infección por SARS-CoV-2, desde el 1 de abril al 31 de agosto del 2020, atendidos en un centro de alta complejidad. Se incluyeron 333 pacientes, 175 (53%) residentes del área Metropolitana de Buenos Aires (AMBA). La mediana de edad fue de 5.5 años (RIC 1.1-10.9) y 177 (53%) eran mujeres. Requirieron internación 209 (63%) y 152 (46%) tenían enfermedad de base. El 89% (n 295) cursó una enfermedad leve/asintomática y el síntoma predominante fue fiebre (n 169, 65%). En el análisis univariado, la enfermedad neurológica (OR 4.5, IC95% 1.9-11, p 0.002), pulmonar crónica (OR 3.9, IC95%1.5-10.3, p 0.002) y genética (OR 11, IC95%3.4-34.4, p< 0.001), así como los síntomas neurológicos (OR 2.8, IC95%1.1-6.6, p 0.035) y respiratorios (OR 20.2, IC95%8.5-48.2, p 0.001) se asociaron a mayor gravedad. Se deberá continuar con la vigilancia activa de aquellos con enfermedad compleja a fin de determinar los efectos de la pandemia en esta población.

Abstract Coronavirus 2 infection has spread rapidly throughout the world. Most of the current publications describe differ ent behavior between an adult and pediatric population, this last one is associated with less clinical severity. The purpose of this study was to analyze the process of care, the epidemiological and clinical features, the evolution and the use of resources in pediatric patients with SARS-Cov-2 infection, treated during the first pandemic wave, at the beginning of 2020. An observational and retrospective study was carried out in the pediatric population with SARS-CoV-2 infection, treated in a highly complex pediatric hospital from April 1 to August 31, 2020. A total of 333 patients were included, 175 (53%) residents of the Metropolitan area of Buenos Aires (AMBA). The median age was 5.47 years (IQR 1.1-10.9) and 177 (53%) were women. A total of 209 (63%) patients required hospi talization and 152 (46%) had an underlying disease. Most of the patients (n 295, 89%) had mild/asymptomatic disease and the main symptom was fever (N169, 65%). In the univariate analysis, neurological disease (OR 4.5, IC95% 1.9-11, p 0.002), chronic respiratory disease (OR 3.9, IC95%1.5-10.3, p 0.002) and genetics (OR 11, IC95%3.4-34.4, p < 0.001), as well as neurological symptoms (OR 2.8, IC95%1.1-6.6, p 0.035) and respiratory (OR 20.2, IC95%8.5-48.2, p 0.001) were associated with more severe disease. Active surveillance of pediatric patients with underlying diseases should continue to define the pandemic's impact on this specific population.

Ocular biometric measurements and central corneal thickness in African pediatric population / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To determine the ocular biometric measurements and central corneal thickness(CCT)in Nigerian children so as to have a reference database.<p>METHODS:A hospital-based observational study of a cross-section of children seen consecutively between November 2017 and January 2018. The socio-demographic data of patients, visual acuity(VA)was assessed with LogMAR charts and Lea charts according to age group. Examination under anesthesia(EUA)was carried out for children eight years and below. Anterior and posterior segments examination through dilated pupil were done. Corneal diameters(CD)were assessed using calipers. Intraocular pressures(IOP)were examined using hand held tonometer, CCT and axial length(AL)were measured using the ultrasonic pachymeter. Cycloplegic refraction was carried out after clinical examination. Data were entered into and analysed using SPSS version 17 to generate results through descriptive statistics. Frequencies and cross tabulations of variables were done(<i>P</i><0.05).<p>RESULTS:Sixty-six children with 132 eyes, of ages between 3-16(mean: 9.13±3.70)years were studied. Male with female ratio was 1:1.7. The modal age group range was 6-10 years(42.4%). Most of them were primary school students 36(54.5%). The predominant parents' occupation was traders/unskilled workers(51.6%)and the professionals/civil servants(30.3%). The mean right and left VA were 0.45±0.46 and 0.45±0.44(LogMAR)respectively. The mean right and left horizontal corneal diameters(HCD)were 10.5±1.6 mm and 10.37±1.45 mm respectively. The mean right and left vertical corneal diameters(VCD)were 9.7±1.2 mm and 9.7±1.3 mm respectively. The mean right and left CCT were 556.71±2.61 μm and 556.47±45.53 μm respectively. Myopia 23(34.8%), myopic astigmatism 18(27.3%)and simple astigmatism 16(24.2%)were the commonest types refractive error. No significant associations were observed between CCT and HCD(<i>P</i>=0.739), VA(<i>P</i>=0.058)and refractive error(<i>P</i>=0.199). However, CCT slightly significantly correlated with the age groups(<i>P</i>=0.055).<p>CONCLUSION: Mean values for CCT, IOP and CD are known for the first time in Nigerian children. No significant association was seen between CCT and VA, CD and refractive errors. Further studies are required to ascertain findings.

Proposal for the management of COVID-19-associated coagulopathy in children / Propuesta para el manejo de la coagulopatía asociada a COVID-19 en niños

Abstract SARS-CoV-2 infection (COVID-19) has become a pandemic with a high case fatality rate that mainly affects adults. Most severely ill adult patients develop a coagulopathy that was not described until recently, and which is currently considered a main cause of death. Everything indicates that a similar phenomenon also occurs in children with COVID-19. Anticoagulant treatment has become one of the therapeutic foundations for this infection; however, its implementation in children can be difficult since, until recently, it was not considered in the pediatric population. Evidence regarding the use of anticoagulants in COVID-19 is rapidly generated, changes constantly, it is often difficult to interpret, and can be contradictory. After an extensive review of the published literature, a proposal was generated that offers suggestions for anticoagulant treatment, considering available resources in Mexico.

Resumen La infección por SARS-CoV-2 (COVID-19) se ha constituido en una pandemia con alto índice de letalidad que afecta principalmente a los adultos. La mayor parte de los pacientes adultos graves desarrolla una coagulopatía que no estaba descrita, la cual actualmente se considera la principal causa de muerte. Todo indica que un fenómeno parecido ocurre también en el niño con COVID-19. El tratamiento anticoagulante se ha convertido en uno de los fundamentos terapéuticos de esta infección; sin embargo, su establecimiento en el niño puede ser difícil ya que, hasta hace poco, no estaba considerado en la población pediátrica. La evidencia respecto al uso de anticoagulantes en COVID-19 se genera con rapidez, cambia constantemente, con frecuencia es difícil de interpretar y puede ser contradictoria. Después de una extensa revisión de la literatura publicada, se generó una propuesta que ofrece sugerencias para el tratamiento anticoagulante en la que se consideran los recursos disponibles en México.

Interrater reliability of fitness gram test to be used as a reliable tool for assessing physical fitness for school children in Guwahati urban society of North-East India

Background: The assessment of physical fitness using a specific tool has become an important part to find out the fitness level of children and adolescence. Fitness gram is a health-related fitness test that utilizes criterion-referenced standards on health-related components. Through the years research has shown that Fitness gram has become one of the most widely used programs in the United States, though it’s used in India is not popular.Methods: Seventy school students in the age group of 5 to 14 years were included in this study and randomly allocated for physical fitness test where 62 students have completed the test. Two physiotherapists as a rater were allotted and children were tested by them with Fitnessgram test battery in a gap of 1 week. Outcome measures includes Fitness gram test battery. Statistical analysis was done by Cronbach’s Alpha value has been computed for the Interrater reliability.Results: Sixty-two students with both gender (male 56.3% and female 43.7%, age -10.12±2.72) were assessed for physical fitness using Fitness gram test battery. All the test variables showed an excellent reliability (Cronbach’s alpha =0.91-0.95).Conclusions: The Fitness gram test battery has been found to be reliable tool and can be implemented for physical fitness test for the children.

Manifestaciones cutáneas en pacientes pediátricos infectados por el coronavirus SARS-CoV-2 / Cutaneous manifestations in pediatric patients infected with SARS-CoV-2 coronavirus

Introducción: El nuevo coronavirus SARS-CoV-2 ha causado un brote grave de la enfermedad denominado COVID-19. El virus fue identificado por primera vez en Wuhan, China, en diciembre del 2019. Recientemente se describieron las manifestaciones cutáneas, con similitud clínica entre niños y adultos. Se identificaron cinco patrones cutáneos: erupción máculo-papular, urticaria, lesiones acrales tipo perniciosas, erupción vesicular y livedo reticularis. Objetivo: Caracterizar a pacientes pediátricos con manifestaciones cutáneas en el curso de la COVID-19. Presentacion de casos: Se estudiaron 10 pacientes pediátricos con COVID-19 ingresados en el Hospital Militar de Villa Clara Comandante Manuel Piti Fajardo. Del total de pacientes, 8 presentaron rash eritemato-papuloso y 2 rash urticariforme. Las lesiones urticariformes se presentaron solamente en las féminas y las eritemato-papulosas, de forma similar en ambos sexos con ligero predominio en las adolescentes pacientes femeninas. Ambas lesiones predominaron en el tronco y acompañadas de un prurito ligero o ausente. Solo requirieron tratamiento médico las lesiones urticariformes. Conclusiones: La principal expresión clínica en la población pediátrica atendida en Villa Clara son las manifestaciones cutáneas. Las lesiones eritemato-papulosas son las más frecuentes, tienen. aparición tardía y evolución favorable sin necesidad de tratamiento y sin acompañarse de otra sintomatología(AU)

Introduction: The new coronavirus called SARS-Cov-2 has caused a severe outbreak of the disease called COVID-19. This virus was identified for the first time in Wuhan, China on December,2019. There were recently described its cutaneous manifestations, with clinical similarities among children and adults. There were identified five cutaneous patterns: macular-papular rash, hives, acral lesions pernicious type, vesicular rash and livedo reticularis. Objective: To characterize pediatric patients with cutaneous manifestations during COVID-19 disease. Cases presentation: There were studied 10 pediatric patients with COVID-19 admitted in ´´Comandante Manuel Piti Fajardo´´ Military Hospital of Villa Clara province. From the total of patients, eight presented eritemato-papular rash and two had urticariform rash. Urticariform lesions were present just in the girls, the eritomato-papulosa lesions presented similarly in both sexes with slight predominance in female adolescents. Both types of lesions appeared with predominance in the torso and accompanied of slight or absent pruritus. Just the urticariform lesions required medical treatment. Conclusions: The main clinical presentations in the pediatric population attended in the Military Hospital of Villa Clara province are the cutaneous manifestations. Eritemato-papular lesions are the most frequent; they have late onset and favorable evolution with no need of treatment and with no other symptomatology(AU)

Characteristics Analysis of Pediatric Drug Clinical Trials Registered in Chinese Clinical Trial Registry / 中国药房

OBJECTIVE：To provi de reference for standardizing pediatric clinical trials and promoting the development and application of pediatric medication in China. METHODS ：Chinese Clinical Trial Registry （Chi CTR ）database were searched to collect all clinical trials related to pediatric population under 18 years old from the inception to Oct. 1st，2019. Those clinical trials were analyzed statistically in respect of name of registered project ，involved disease/system ，research stage ，registration time ， registration status ，regional distribution of research institutions ，source of funds ，research type ，whether data management committee was set up ，situation of recruited research objects ，ethics committee approval status ，whether blind method was adopted ， whether to collect human specimens and whereabouts of human specimens. RESULTS ：A total of 231 pediatric drug clinical trials were included. The clinical trials involved 21 kinds of diseases/systems ，mainly were tumors and tumor-like lesions ，ophthalmic diseases and allergic disease. The research stage has the most items （85 trials，36.80％）in post-marketing drug clinical trials ；there were 77 items of phase Ⅰ-Ⅳ clinical trials （33.33％）. The number of pediatric drug clinical trials was increased year by year ，and among which 179 trials were pre-registered （77.49％），52 trials were supplementary registration （22.51％）. Beijing ，Shanghai， Guangdong，Chongqing and Zhejiang were the major regions where pediatric drug clinical trials were carried out ，and the clinical trial projects of which accounted for 66.23％（153/231）of the total number of included projects. The funding sources were mainly self-financing（57.85％），hospital finance （20.18％），and local government finance （10.31％）. The main type of research was intervention study and observational study ，accounting for 88.31％ in total. Totally 145 trials（62.77％）had not yet determined whether to set up a data management committee ；201 trials（87.01％）had passed the review of the ethics committee of the relevant institution；168 trials（72.73％）did not clarify whether the blind method was used ；133 trials（57.58％）had collected 001-001） human specimens ，and the collected human specimens were 3360875。E-mail：794446155@qq.com mainly destroyed after use. CONCLUSIONS ：The number of pediatric drug clinical trials registered in Chi CTR is increasing but there i s regional imbalance. Researchers have gradually established the concept of pediatric clinical trial registration ，and have realized the importance of data management to research quality ，and the management of collected trial specimens is relatively standardized. It is suggested that relevant departments increase the publicity of clinical trial registration and improve the clinical trial registration management system ； relevant researchers should increase the awareness of clinical trial registration ，standardize registration application and trial project management.

Leucotrienos urinarios en pacientes pediátricos con trastorno respiratorio del sueño secundario a hiperplasia adenoamigdalina / Urinary leukotrienes in pediatric patients with sleep disordered breathing secondary to adenotonsillar hypertrophy

RESUMEN Introducción: El trastorno respiratorio del sueño (TRS) afecta al 2% a 3% de la población pediátrica, siendo la hiperplasia adenoamigdalina (HAA) su principal causa. Se ha observado un aumento en los niveles de leucotrienos excretados en orina (LTU) en estos pacientes, los cuales se correlacionarían con la severidad de la enfermedad. Objetivo: Determinar el nivel de LTU en niños con TRS e HAA antes y después de adenoamigdalectomía (AA), y en controles sanos. Correlacionar los niveles de LTU con los síntomas de TRS. Material y método: Estudio prospectivo. Se incluyeron pacientes con TRS e HAA (n =12) y controles sanos (n =12). Se determinó la concentración de LTU en ambos grupos de forma basal y un mes después de cirugía en el grupo con TRS. Resultados: No hubo diferencias en los niveles de LTU antes y después de AA. Tampoco existieron diferencias entre el grupo control y grupo TRS previo a la cirugía. No se encontró asociación entre LTU y la severidad de síntomas respiratorios. Conclusión: Los LTU no se encuentran elevados en pacientes con TRS e HAA, no disminuyen luego de AA y no se correlacionan con la severidad de los síntomas. La medición de LTU no sería una herramienta útil en la evaluación de pacientes con TRS. Nuevos estudios son necesarios para evaluar el rol de los leucotrienos en esta enfermedad.

ABSTRACT Introduction: Sleep disorder breathing (SDB) affects 2%-3% of the pediatric population, being adenotonsillar hyperplasia (ATH) its main cause. An increase in the levels of urinary leukotrienes (ULT) has been measured in these patients, which could be correlated with the severity of the disease. Aim: To determine the level of ULT in children with SDB and ATH before and after adenotonsillectomy, and healthy controls. To correlate the levels of ULT with symptoms of SDB. Material and method: prospective study. SDB and ATH patients (n =12) and healthy controls (n =12) were included. The concentration of ULT in both groups was determined, before surgery and after a month of surgery. Results: There were no differences in the levels of ULT before and after tonsillectomy in the studied group. There were also no differences between the control group and the SDB group. No association was observed between the level of ULT and the severity of respiratory symptoms. Conclusions: ULT are not elevated in patients with SDB and ATH and they do not decrease after adenotonsillectomy. ULT are not correlated with the severity of the symptoms of SDB. The measurement of ULT would not be a useful tool in the evaluation of patients with SDB. New studies are needed to assess the role of the role of leukotrienes in this disease.

Aetiological profile of fever in neonatal and paediatric population in hospital setting

Background: Febrile illness in children is a common cause of admission to hospital globally, with significant associated morbidity and mortality. Dengue, malaria, scrub typhus, typhoid and leptospirosis have been identified as major causes of acute undifferentiated febrile illness in Thailand, Malaysia, and Nepal. Climate variation, over population and urbanization may all contribute to the emergence and reemergence of infections in tropical regions like Tamil Nadu. The objectives of this study were to describe the aetiology of fever in hospitalized neonatal and Pediatric population. A descriptive study was designed.Methods: A prospective observational study was conducted. All children from 0 to 18 years admitted as in-patients. Sample size was calculated to be 650. Basic laboratory tests were done in all cases.Results: Out of a total of 650 children maximum number (40.7% n=265) of patients had short duration of fever between 1 to 3 days. Majority (56%) of patients had temperature between 100.4 to 101F. Only 5 children were confirmed to have malaria. Maximum number of pus cells found was 80 to 100 in 3 children in urine examination. Total Infectious cases were 631 (97.07%).Conclusions: Infectious aetiology was more common than non-infectious aetiology. Among all aetiologies, viral fever particularly dengue was the most common aetiology. Enteric fever was the second most common infectious cause of fever after viral fever.' Short febrile illness (1 to 5 days) was the most common type of fever in children admitted in hospital. In neonates, the most common cause of fever was probable sepsis followed by dehydration fever.

Bloodstream Infections in Pediatric Population in a Tertiary Care Hospital

Introduction: In paediatric patients blood stream infection(BSI) is the leading cause of mortality and morbidity. Theemerging of causative agents and resistance to variousantimicrobial agents are increased from time to time. The aimof this study was to describe the microbiological characteristicsof BSI in paediatric patients (<12 years). Neonates wereexcluded.Material and Methods: Data was collected from paediatricpatients who had BSI. Blood culture was done in BacT Alert3D. Isolates from these patients were identified on Vitek IICompact. Study was done between from January 2018 toDecember 2018 at Paediatric hospital GMC Srinagar.Results: A total of 120 patients had BSI. All episodes weremonomicrobial.78 (65%) were males and 42 (35%) werefemales. 67 (56%) of the isolates were Gram positive bacteriaand 53 (44%) were Gram negative. The commonest Grampositive bacterial isolates were Staphylococcus aureus 52(78%) followed by Coagulase negative Staphylococci (CoNS)8 (12%), Enterococcus fecalis 4(6%) and Streptococcuspneumonia 3(4%).Conclusion: Majority of the isolates were multidrug resistant.These higher percentages of multi-drug resistant emergedisolates urge us to take infection prevention measures and toconduct other large studies for appropriate empiric antibioticchoice.

The Exploration of Extrapolation of Data from Adults to Pediatric Population / 中国医疗器械杂志

Pediatric medical devices cannot meet the existing medical needs now. In consideration of the difficulty that clinical trials conducted in pediatric population, reasonable extrapolation of adult device data to pediatric population can maximize the use of existing data, as well as reduce unnecessary clinical trials in pediatric populations. It can also help accelerate the development and marketing of pediatric medical devices and ensure the clinical demand of pediatric devices. We analyzed the related guiding principles in America, and explored the extrapolation of medical device data to pediatric population in China from the perspective of medical device technology evaluation, hoping to provide reference in promoting China's data extrapolation.

Características de la atención pediátrica ambulatoria de familias nativas y migrantes / Characteristics of pediatric outpatient care of Argentine native and immigrant families

Introducción: Los procesos migratorios han aumentado a nivel mundial por múltiples causas. En nuestro país un 4.5% de población es extranjera y el 69% proviene de países limítrofes. La ley de Migraciones N°25.871 garantiza el goce igualitario de derechos a migrantes extranjeros y argentinos. La comuna 8 (CABA) presenta 19.9% de población extranjera. Su primer Nivel de Atención está a cargo, entre otros, de los Centros de Salud y Acción Comunitaria N° 5 y 18. El Hospital Juan P. Garrahan es centro de derivación regional. El objetivo de la investigación fue describir las características de la respuesta del Sistema de Salud, específicamente, comparar el acceso al primer nivel de prevención y la satisfacción con la actividad asistencial entre familias migrantes extranjeras y nativas. Métodos: Estudio multicéntrico, observacional y de corte transversal a través de entrevistas semiestructuradas a familias migrantes extranjeras y nativas entre Julio 2014 y Junio 2015. Los resultados se expresaron en frecuencias y porcentajes en forma global y comparativa entre ambos grupos. Resultados: Se encuestaron 287 familias, 52% nativas y 48% migrantes extranjeras. Se encontró menor acceso a trabajo formal en las últimas. Ambos grupos presentaron dificultad en la obtención de turnos, percibiendo trato más amable las primeras y mayor comprensión de indicaciones las segundas. En la asistencia médica se halló menor posibilidad de cumplir con indicaciones en familias migrantes. Conclusión: Los resultados reflejan similares características de atención pediátrica ambulatoria para familias nativas y migrantes extranjeras (AU)

Introduction: Migration has increased worldwide due to multiple causes. In our country, foreigners account for 4.5% of the population of whom 69% come from neighboring countries. The Law of Migration N°25.871 guarantees equal rights for immigrants and Argentinians. In Commune 8 (City of Buenos Aires) 19.9% of the population is foreign born. Their primary care attention is covered by, among others, Health Care and Community Action Centers N° 5 and 18. Hospital Juan P. Garrahan is a regional referral center. The aim of this study was to describe the characteristics of the response of the Health Care System, specifically, comparing access to and satisfaction with first-level care and disease prevention among immigrant and native Argentinian families. Methods: A multicenter, observational, cross-sectional study was conducted through semi-structured interviews with immigrant and native Argentinian families between July 2014 and June 2015. Results were expressed in rates and percentages overall and comparing both groups. Results: 287 families were interviewed, 52% were native and 48% immigrants. Reduced access to formal employment was found in the latter group. Both groups reported difficulties in obtaining appointments, perceiving a more friendly treatment in the former and better understanding of the indications in the latter group. Regarding medical care, less possibilities to adhere to the indications were found in immigrant families. Conclusion: Our results show similar pediatric outpatient health-care characteristics for native and immigrant families (AU)

Parental awareness, knowledge, and attitude toward conscious sedation in North Indian children population: A questionnaire-based study

The purpose of this study is to find the opinion, attitude, beliefs, and the existing knowledge of parents of Himachal Pradesh suburban city about conscious sedation. Objective: To know the effect of education of parent and prior sedation experience of the child on opinion, attitude, and knowledge of parent about conscious sedation. Methodology: A questionnaire in Hindi/English was provided to parents who accompanied their child for the treatment in the Paedodontics Department of HPGDC College Shimla. Information regarding demography, existing knowledge gained through television, the internet, opinion about the safety of the procedure, knowledge of nothing by mouth guidelines, restraints usage, and knowing their preferences of staying with the child during treatment was explored. Questions were straight yes or no type and multiple choice type. Some questions were statements and wanted the respondents to strongly agree, agree, disagree, or strongly disagree. Results and Conclusion: A total of 350 questionnaires were collected. Parents feel sedation is safe in the dental office as an adjunct to dental treatment. Education played a role in existing knowledge about sedation and perception about the safety of conscious sedation.

Actualización en: El trastorno neuromuscular, un reto diagnóstico / Update on: Neuromuscular disorder, a diagnostic challenge

Los trastornos neuromusculares (TNM) son una causa frecuente de morbilidad pediátrica. Muchos de estos trastornos, generan a largo plazo una discapacidad progresiva en el niño/a, por lo cual, el diagnóstico oportuno es elemental. Como es común con otras afecciones médicas, el punto de partida del proceso diagnóstico es una detallada historia clínica y un examen físico completo. Este abordaje, esencialmente clínico, permite establecer un diagnóstico sindromático inicial y posteriormente orientarnos hacia cuadros específicos que nos permitan dirigir la solicitud de los estudios complementarios. El laboratorio neuromuscular comprende una serie de exámenes que complementan la identificación de estos cuadros y nos permiten el planteamiento de un diagnóstico diferencial entre fenotipos muy similares. Los objetivos de la investigación diagnóstica son los de ofrecer un consejo genético, definir un pronóstico futuro y establecer un plan de tratamiento actualizado, orientado a mantener la funcionalidad, prevenir las complicaciones y mejorar la calidad de vida de cada paciente. Este artículo tiene como finalidad, brindar herramientas de abordaje diagnóstico pediátrico, del niño/a que se presenta a la consulta médica, con síntomas sugestivos de un trastorno neuromuscular

Neuromuscular disorders (NMS) are a common cause of pediatric morbidity. Many of these disorders, in the long term, create a progressive disability in the child, so that timely diagnosis is essential. As is common with other medical conditions, the starting point of the diagnostic process is a complete and detailed medical history and physical examination. This approach, mainly clinical, makes it possible to establish an initial syndromic diagnosis and then to orient ourselves to specific charts and direct the request for complementary studies. The neuromuscular laboratory includes a series of tests that complement the identification of these charts and allow us to approach a differential diagnosis between common phenotypes. The objectives of the diagnostic investigation are to offer genetic counseling, to define a future prognosis and to establish an updated treatment plan, aimed at maintaining the functionality, preventing complications and improving the quality of life of each patient. This article aims to provide tools for a pediatric diagnostic approach of the child who presents to the medical consultation, with symptoms suggestive of a neuromuscular disorder

Leishmaniasis: Opciones terapéuticas en la población pediátrica / Leishmaniasis: Therapeutic options in the pediatric population

Resumen La leishmaniasis es una enfermedad parasitaria crónica endémica en muchas partes del mundo. La variabilidad de cepas, su clínica y respuesta a tratamiento ha hecho que se clasifique en dos grandes grupos: la leishmaniasis del Nuevo Mundo y la del Viejo Mundo. Según esto, varían las recomendaciones respecto a manejo y seguimiento. En esta revisión se hace énfasis a la leishmaniasis de nuestro medio, revisando opciones terapéuticas y posibilidades principalmente en la población pediátrica.

Abstract Leishmaniasis is a chronic parasitic disease endemic in many parts of the world. The variability of strains, their clinic and response to treatment has led to their classification into two major groups: New World leishmaniasis and Old World leishmaniasis. According to this, the recommendations regarding management and follow-up vary. In this review, emphasis is placed on leishmaniasis in our environment, reviewing therapeutic options and possibilities mainly in the pediatric population.

Relationship between body weight and postmenstrual age in a Korean pediatric population

Weight is a covariate representative of body size and is known to influence drug disposition. Recently, with increased use of allometric scaling, this variable has become more significant in accounting for variability in pharmacokinetic parameters. In adults, weight can be considered as a time invariant covariate because physical development is complete. As a result, when weight is missing in data, the typical or median value (say, 70 kg) could be imputed. On the contrary, weight continuously changes with age in the pediatric population. In this case, it is more appropriate to consider different median weight for each age group. We constructed a prediction model for weight using postmenstrual age (PMA) with the data consisting of 83,014 Korean pediatric patients. Weight, PMA, and gender information were collected from electronic medical records. Sigmoid models multiplied by exponential or logistic function were tested for basic model structure. Covariate effects on model parameters were then investigated using selection criteria of p < 0.001. All analyses were performed using NONMEM 7.3.0 and R3.2.0. The sigmoid model multiplied by logistic function best described the data and there was a significant difference between boys and girls in model parameters. It is expected that the results obtained in this work can be used for imputation of missing weights in pediatrics when PMA is available. In addition, the developed model can be used for clinical studies in children under 12 years old whose weight change rapidly with age and for model building in dealing with time varying body weight as a covariate.

Prevalence of oral mucosal lesions in children / Prevalencia de lesiones de la mucosa oral en niños

Lesions of the oral mucosa are a broad range of different alterations located in the soft tissue of the oral cavity. The studies that describe the prevalence of oral mucosal lesions have been carried out mainly in an adult population. Therefore, in the literature available both in Chile and abroad, there are few reports about pathological lesions and alterations of the normality of the oral mucosa in pediatric population. A descriptive observational cross-sectional study was conducted, with non-probability sampling for convenience, with a sample of 219 patients and a level of confidence of 95 %. We estimated 30 % of children with oral mucosal lesions. Patient history and the presence of oral mucosal lesions were registered in the clinical records specific to this study. In 101 patients a prevalence of 37.62 % of oral mucosal lesions was observed. The most frequent lesion was the minor aphthous ulcer (6.9 %), followed by irritation fibroma (5 %), traumatic ulcer (5 %), traumatic erosion (4 %), impetigo (4 %), pigmented lesion (3 %), and others, at lower rates. The most prevalent location was the lips with a 38.5 %.

Las lesiones de la mucosa oral comprenden un amplio conjunto de alteraciones que se localizan en los tejidos blandos de la cavidad oral. Los estudios que describen la prevalencia de lesiones de mucosa oral, se han realizado principalmente en población adulta, por lo tanto en la literatura internacional y en Chile, existen escasos reportes acerca de lesiones patológicas y alteraciones de la normalidad de mucosa oral en población pediátrica. Se realizó un estudio observacional, descriptivo y transversal, de tipo no probabilístico por conveniencia, donde se calculó una muestra de 219 pacientes con un nivel de confianza de 95 %. Se estimó un porcentaje de 30 % de niños con lesiones de mucosa oral. Se registró la anamnesis del paciente y presencia de lesiones de mucosa oral en la ficha clínica específica para el estudio. Se observó en 101 pacientes una prevalencia de 37,62 % de lesiones de mucosa oral. La lesión más frecuente fue el afta menor, seguido de fibroma irritativo, úlcera traumática, erosión traumáticas, impétigo, lesiones pigmentadas y entre otras con menor frecuencia. La localización más prevalente fue los labios con 38,5 %.

Therapy-related myeloid neoplasms in children and adolescents

BACKGROUND: This retrospective study aimed to characterize and analyze the outcome of therapy-related myeloid neoplasms (t-MNs) in children and adolescents. METHODS: The medical records of 16 patients under 21 years of age at the time of t-MN diagnosis were reviewed. RESULTS: The median patient age was 11.5 years (range, 1.6–20.4 yr). Twelve patients had therapy-related acute myeloid leukemia, 3 patients had myelodysplastic syndrome, and 1 patient had chronic myelomonocytic leukemia. The median latency period was 29 months (range, 11–68 mo). Fourteen patients had cytogenetic aberrations, 8 of whom had an 11q23 abnormality. Of the 13 patients treated with curative intent, 12 patients received myeloid-type induction therapy that led to complete remission (CR) in 8 patients. Nine patients underwent allogeneic transplantation; 4 patients did not undergo transplantation due to chemotherapy-related toxic death (N=3) or parental refusal (N=1). The 5-year overall survival and event-free survival of the 13 patients treated with a curative intent were 46.2% and 30.8%, respectively. For the 9 patients who underwent allogeneic transplantation, the 5-year event-free survival was 66.7%. CONCLUSION: A significant proportion of young patients with t-MNs can experience long-term survival, and allogeneic transplantation plays a key role for attaining cure in these patients.